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Posts Tagged ‘Fraud Convictions’

Special Investigations Dept nets 6 convictions in July

The BWC Special Investigations Department netted six convictions in July in criminal cases related to workers’ compensation fraud.

“Workers’ comp fraud is not only illegal, it impacts the entire workers’ comp system designed to protect Ohio workers and employers in the event of a workplace injury,” said BWC Administrator/CEO Sarah Morrison. “Putting an end to fraud safeguards employer premiums that should be going toward helping injured workers return to health and back on the job as soon as possible.”

As of July 31, BWC’s Special Investigations Department had secured 61 convictions for the calendar year. July convictions include:

Mike G. Abro (Cuyahoga County)
Investigators found Abro was operating several Happy’s Pizza franchise locations in Northeast Ohio with multiple BWC policies in which coverage was lapsed.  Abro worked with BWC to bring several policies back into compliance, but failed to become compliant at his East Cleveland location.

Abro pleaded guilty July 6 in Cuyahoga County Common Pleas Court to one count of failure to comply, a second-degree misdemeanor. He was sentenced to 90 days incarceration, suspended, and ordered to serve one year of non-reporting probation. As a condition of his probation, Abro was ordered to bring the lapsed policy into compliance. He made a $15,000 payment in June, and must enter into a payment plan on his remaining balance of approximately $18,000 in order to become compliant with the law.

Shannon Graham (Lorain County)
Investigators found Graham had returned to employment as a medical records and scheduling coordinator with a retirement community while receiving temporary total disability benefits by a self-insured employer.

Graham pleaded guilty July 26 in Cuyahoga County Common Pleas Court to one count of falsification, a first-degree misdemeanor. She made an initial restitution payment of $2,500. She was sentenced to a 180 days jail, suspended for one year of community control, and ordered to pay restitution in the amount of $3,200.

Diane Kaiser (Franklin County)
Investigators found Kaiser working for an insurance company while also receiving temporary total disability benefits from BWC. Kaiser pleaded guilty July 11 in Franklin County Common Pleas Court to one count of attempted workers’ compensation fraud, a first-degree misdemeanor. She was ordered to pay $1,734 in restitution and $500 in investigative costs to BWC.

Donald Rasmussen (Lucas County)
Investigators found Rasmussen was working as a truck driver while receiving temporary total disability payments from BWC. Rasmussen pleaded guilty July 26 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. The judge sentenced Rasmussen to 60 days in jail, suspended for one year if he has no other convictions. Rasmussen paid $29,720 in restitution to BWC prior to his plea.

De’Ericka Vason (Cuyahoga County)
Investigators found Vason working as a day care worker while collecting temporary total disability payments from BWC. Vason pleaded guilty July 5 in Franklin County Common Pleas Court to one count of workers’ compensation fraud, a first-degree misdemeanor. Vason was sentenced to 180 days in jail, suspended for three years of community control, and ordered to pay restitution in the amount of $2,235 to the BWC.

Ryan Somnitz (Sherrills Ford, North Carolina)
Acting on an anonymous tip, investigators found Somnitz was not fulfilling the educational requirements he needed to receive dependent death benefits. He was required to be pursuing a full-time educational program while enrolled in an accredited educational institution. Investigators, however, found Somnitz consistently and knowingly remained in part-time student status and withheld from BWC that he was not a full-time student. Somnitz pleaded guilty July 11 to one count of workers’ compensation fraud, a fifth-degree felony. He is scheduled for sentencing Aug. 24.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Marion trucking company owner failed to maintain workers’ comp coverage

MARION – A Marion employer who allowed his workers’ compensation policy to lapse and claimed his employees were subcontractors has been sentenced for failing to comply with the law. Lakhvir S. Sidhu, owner of Liverpool Express, was sentenced Dec. 7 after he failed to cooperate with attempts by the Ohio Bureau of Workers’ Compensation (BWC) to help him obtain proper coverage.

“BWC makes good faith attempts to work with businesses to bring them into compliance, but has no choice but to pursue fraud charges when our efforts are ignored,” said BWC Administrator/CEO Steve Buehrer. “Businesses with employees must comply with the law and maintain workers’ comp coverage to protect their workforce.”

BWC’s Employer Compliance Department first attempted to work with Sidhu to bring his policy into compliance but investigators with the agency’s Special Investigations Department opened a fraud investigation after Sidhu did not cooperate.

An audit on the business showed Sidhu was paying wages to employees he claimed were subcontractors. Investigators interviewed Sidhu on several occasions regarding the lapsed policy and the requirement to report wages for his employees. After meeting with agents, Sidhu paid his past due premiums, although he still claimed the workers were subcontractors. The investigation later revealed that Sidhu reported employee wages to the Ohio Department of Jobs and Family Services that totaled $266,000 more than the wages he reported to BWC for the same time period.

The matter was then reviewed by the Marion City Law Directors office after Sidhu failed to enter into a payment plan and/or file the additional payroll information as requested by agents. He was convicted of a second-degree misdemeanor count of failure to comply with the law and was ordered to pay restitution in amount of $3,724.77, and comply with BWC regulations and Ohio laws. Sidhu must also pay fines totaling $400 and serve 90 days of incarceration, suspended for two years community control.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov. Check out our latest cases at ohiobwcfraud.wordpress.com, and see what workers’ compensation fraud looks like in our fraud awareness video on YouTube.

BWC investigations result in five workers’ comp fraud convictions in November

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer announced today that five individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in November 2015. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).

“Identifying and weeding out fraud is an essential part of not only maintaining fairness, but keeping workers’ comp costs manageable for Ohio employers,” said Buehrer.

The following is a summary of the cases that resulted in guilty pleas or convictions in November:

Latonia Almon (Columbus, Franklin County) pleaded guilty Nov. 16 to a fifth-degree felony count of workers’ compensation fraud in the Franklin County Court of Common Pleas for working while receiving benefits. A cross match with the Ohio Department of Job and Family Service conducted by BWC’s Intelligence Unit identified Almon as possibly working while receiving temporary total disability benefits. SID obtained employment records that revealed Almon she continued to work as a home health aide during the entire period she was collecting benefits for a workplace injury. During an interview, Almon admitted to “kinda” working and receiving payment for the services she provided. Almon admitted she did not inform the BWC of this employment. A pre-sentence investigation has been ordered and sentencing is scheduled for January 15, 2016.

Robert Aleshire (Delta, Fulton County) pleaded guilty Nov. 3 in the Franklin County Court of Common Pleas to a fifth-degree felony count of theft for working while receiving benefits. SID’s Intelligence Unit identified that Alshire was involved in a Public Utilities Commission of Ohio (PUCO) motor vehicle inspection as a commercial truck driver while he was collecting permanent total disability benefits from BWC. The investigation found that Aleshire was driving as an independent contractor under the name MoMo Trucking. The judge ordered a pre-sentence investigation and Aleshire is scheduled to be sentenced on January 13, 2016.

Sandra Houshel (Dayton, Montgomery County) pleaded guilty Nov. 19 in the Franklin County Municipal Court to one first-degree misdemeanor count of workers’ compensation fraud for working while receiving benefits. The judge ordered her to pay a fine of $100 plus court costs. SID began investigating after receiving an allegation that Houshel was working at a restaurant in downtown Dayton while collecting temporary total disability benefits for a workplace injury. The investigation found that Houshel was working at the restaurant most the week, opening the restaurant and working as a waitress. Houshel immediately paid the full restitution of $3,369.24 to the court.

Mike Crawley (Shelbyville, Indiana) pleaded guilty Nov. 16 in the Darke County Court of Common Pleas to one fifth-degree felony count of workers’ compensation fraud for working while receiving benefits. SID began investigating after receiving an allegation that Crawley may be working for a local trailer park. The investigation found that Crawley performed various maintenance work at the mobile home park while collecting temporary total disability benefits from BWC. Crawley is scheduled to be sentenced on January 16, 2016.

Rachel Madison (Bedford, Cuyahoga County) pleaded guilty Nov. 23 in the Franklin County Court of Common Pleas to a fifth-degree felony count of workers’ compensation fraud for improperly receiving dependent death benefits. Madison was eligible to receive death benefits up to age 25 if enrolled at an accredited educational institution. SID received an allegation that she was submitting proof of college enrollment to the BWC in order to receive the benefits but was not attending the classes. Madison’s course schedule from the University of Akron showed that either she failed to attend classes or did not remain in full-time status. She failed to report to BWC that she did not attend classes and was not enrolled as a full-time student but submitted paperwork to BWC in order to continue receiving the benefits. Madison was sentenced to six months in prison, suspended for five years of community control. As a condition of her probation, she is required to pay $12,319.98 in restitution.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Check out our latest cases at ohiobwcfraud.wordpress.comand view BWC’s workers’ comp fraud awareness video on YouTube.

Wayne County realtor pleads guilty to workers’ comp and social security fraud

James Miller of West Salem (Wayne County) recently pleaded guilty to workers’ compensation and social security fraud and has been ordered to repay more than $30,000.

BWC’s Special Investigations Department began investigating Miller after receiving an allegation that he was working as a realtor while receiving living maintenance wage loss statements. This benefit is available to an injured worker who has completed a rehabilitation plan but continues to have physical restrictions and experiences a wage loss upon return to work.

Internet research showed Miller had listings and recent sales with Howard Hanna and employment and bank records revealed he had received numerous paychecks from the company. However, he had been submitting paperwork to BWC showing he had no earnings.

Miller admitted to earning the money as a realtor but claimed that his expenses as a realtor were so great that he earned $0.  However, as part of his benefits, BWC had paid for these expenses previously and were not out-of-pocket expenses to Miller. Additionally, it was discovered that Miller was receiving monthly benefits from the Social Security Administration (SSA).

Miller entered a guilty plea to two felony counts of theft and two felony counts of tampering with records in an Ashland County courtroom. The plea represents two counts for BWC and two for SSA.

The judge sentenced Miller to 150 days of house arrest with GPS monitoring for each count, which will run concurrently. Additionally, Miller will serve four years of probation supervision and 250 hours of community service.  Conditions of community control include the payment of restitution to BWC in the amount of $11,081.68 and $20,878.79 to the SSA. Miller was also ordered to pay a fine of $ 1,000.

He will face 18 months of prison time if he fails to abide by the sanctions imposed by the court.

Logan County fire chief pleads guilty to workers’ compensation fraud

Donald Detrick booking photoColumbus – The chief of the Bokecreek Fire Department in Logan County paid more than $25,000 in restitution to the Ohio Bureau of Workers’ Compensation (BWC) this week after pleading guilty to workers’ compensation fraud. Donald Detrick appeared in the Franklin County Court of Common Pleas on Oct. 27 following a BWC investigation that found he worked three jobs while collecting workers’ compensation benefits.

“BWC’s goal is to assist injured workers so they can recover and return to their jobs as quickly as possible,” said BWC Administrator/CEO Steve Buehrer. “The type of benefit Mr. Detrick was receiving is reserved for those whose injuries prevent them from returning to work. That’s why the money he has returned will be put back into our fund and be used to provide compensation and medical care to truly injured workers.”

BWC’s Special Investigations Department opened an investigation after receiving an allegation that Detrick, of West Mansfield, may be working while receiving benefits for a workplace injury. The investigation revealed that Detrick worked as the fire chief for Bokecreek Township in Logan County, fire safety coordinator for York Township in Logan County and as a certified water inspector for Midwest Express while collecting temporary total disability benefits.

Prior to the plea, Detrick paid $25,586.40 to the Clerk of Courts in order to pay in full his restitution of $22,155.04 and investigative costs of $3,431.36. A judge sentenced him to community control for six months under the condition that he pay the restitution and investigative costs, have no new convictions, and pay all court costs. He will serve six months in jail if he does not meet these terms.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov. Check out our latest cases at ohiobwcfraud.wordpress.com, and see what workers’ compensation fraud looks like in our fraud awareness video on YouTube.

BWC investigations result in seven workers’ comp fraud convictions in September

Columbus – Ohio Bureau of Workers’ Compensation (BWC) Administrator/CEO Steve Buehrer announced today that seven individuals were convicted of, or pleaded guilty to, charges related to defrauding Ohio’s workers’ compensation system in September 2015. These court actions are the result of investigations conducted by BWC’s Special Investigations Department (SID).

“The cases this month show workers’ comp fraud comes in many forms, including businesses that don’t maintain coverage to protect their workers,” said Buehrer. “We’ll continue to fight this kind of fraud, just as we intend to put a stop to any claimants who knowingly return to work in order to maintain their workers’ comp benefits.”

The following is a sampling of cases that resulted in guilty pleas or convictions during September:

Joshua W Shoaff, dba JWS Window Cleaning, (Uniontown, Stark County) pleaded guilty Sept. 14 to one first-degree misdemeanor count of workers’ compensation fraud for altering his certificate of coverage. SID received an allegation from the BWC Safety Violations Investigations Unit that Shoaff’s business, JWS Window Cleaning, had multiple claims filed against the business and its policy had lapsed. The Employer Fraud Team’s investigation found a BWC certificate of coverage that had been intentionally altered by the employer in attempt to show valid BWC coverage to a potential client. Shoaff was sentenced in the Stark County Court of Common Pleas to probation and ordered to continue making payments on the outstanding debt owed to BWC after he took the necessary steps to reinstate his policy.

Patrice Myers (Columbus, Franklin County) pleaded guilty Sept. 9 to one first-degree misdemeanor count of workers’ compensation fraud for working while receiving benefits. SID began investigating after receiving an allegation that Myers was working at a pharmacy while receiving benefits for a workplace injury. The investigation found that Myers did work at the pharmacy while receiving temporary total disability benefits. Claimants are not permitted to work while receiving this type of benefit. SID obtained employment records that confirmed Myers was paid every two weeks and worked approximately 30 to 40 hours per week during the same time period she received the benefits. Myers was ordered in a Franklin County courtroom to pay $7,566.24 in restitution to BWC, and sentenced to 180 days in jail, suspended for five years of community control.

Brent Taylor (Nelsonville, Athens County) pleaded guilty Sept. 14 to one misdemeanor count of workers’ compensation fraud for working while receiving benefits. SID opened an investigation after receiving an allegation that Taylor was engaged in work activity while he was receiving temporary total disability benefits for a workplace injury. The investigation revealed Taylor knowingly engaged in work activities while receiving this benefit that does not permit a return to work. Specifically, the investigation confirmed he worked as a girls’ basketball coach and provided lawn care services while concealing his activities from BWC. A Franklin County judge placed Taylor on five years of community control and ordered to pay $30,000 in restitution, with $13,500 to be paid at the time of the plea, in addition to $1,750 in investigative costs. Taylor submitted $13,500 to the Franklin County Clerk’s Office prior to his plea.

Angel Cardona (Columbus, Franklin County) pleaded guilty Sept. 22 to one fifth-degree felony count of workers’ compensation fraud for working while receiving benefits. SID initiated an investigation after receiving an allegation that Cardona was working and receiving compensation at the same time. The investigation, which included surveillance, a review of bank records and interviews, found Cardona was gainfully employed with Marvin Cruz and Mountaineer Framing and Roofing during periods for which he also received temporary total and living maintenance benefits. The evidence obtained during the course of the investigation revealed Cardona intentionally misrepresented and withheld his employment in order to collect BWC benefits. Cardona was sentenced to 12 months in prison, suspended, for four years of community control. He was also ordered to pay $83,892.86 in restitution to BWC.

To report suspected workers’ compensation fraud, call 1-800-644-6292 or visit bwc.ohio.gov.

Check out our latest cases at ohiobwcfraud.wordpress.com and view BWC’s workers’ comp fraud awareness video on YouTube.